Analysis of §1115 Waiver Renewal: Whole Person Care Pilots

This is part of an ITUP series on the Medi-Cal 2020 §1115 waiver renewal.

As health care systems are focusing on providing more efficient, high quality care, systems around the country are moving towards more integrated patient care. The addition of the Whole Person Care Pilots (WPC) in California’s new §1115 waiver aims to do just this by better coordinating health, behavioral health, and social services for Medi-Cal patients. The goal is that this will lead to more effective and efficient use of resources, while improving patient health. The new program recognizes the need for improved coordination of care within and across system and the importance of addressing the conditions that shape health in the environments where people live, work, and play.

These pilots recognize that an individual’s health is dependent on several external factors outside of a visit to a health care facility. The pilot seeks to bring entities such a community organizations, health care systems, and counties, together to address these issues.

The WPC pilots are designed to encourage innovation in delivery and financing strategies to improve health outcomes of target populations. The pilot aims to improve health outcomes, reduce per capita costs and improving patient experience. By reducing duplication of effort and more efficiently addressing patient needs, a whole-person care approach could improve the health for Medi-Cal population and have positive impact in other publicly financed systems such as behavioral health, social services, education, and public safety.